Minimal residual disease in myeloma: Application for clinical care and new drug registration Review


Authors: Anderson, K. C.; Auclair, D.; Adam, S. J.; Agarwal, A.; Anderson, M.; Avet-Loiseau, H.; Bustoros, M.; Chapman, J.; Connors, D. E.; Dash, A.; Di Bacco, A.; Du, L.; Facon, T.; Flores-Montero, J.; Gay, F.; Ghobrial, I. M.; Gormley, N. J.; Gupta, I.; Higley, H.; Hillengass, J.; Kanapuru, B.; Kazandjian, D.; Kelloff, G. J.; Kirsch, I. R.; Kremer, B.; Landgren, O.; Lightbody, E.; Lomas, O. C.; Lonial, S.; Mateos, M. V.; de Oca, R. M.; Mukundan, L.; Munshi, N. C.; O'Donnell, E. K.; Orfao, A.; Paiva, B.; Patel, R.; Pugh, T. J.; Ramasamy, K.; Ray, J.; Roshal, M.; Ross, J. A.; Sigman, C. C.; Thoren, K. L.; Trudel, S.; Ulaner, G.; Valente, N.; Weiss, B. M.; Zamagni, E.; Kumar, S. K.
Review Title: Minimal residual disease in myeloma: Application for clinical care and new drug registration
Abstract: The development of novel agents has transformed the treatment paradigm for multiple myeloma, with minimal residual disease (MRD) negativity now achievable across the entire disease spectrum. Bone marrow-based technologies to assess MRD, including approaches using next-generation flow and next-generation sequencing, have provided real-time clinical tools for the sensitive detection and monitoring of MRD in patients with multiple myeloma. Complementary liquid biopsy-based assays are now quickly progressing with some, such as mass spectrometry methods, being very close to clinical use, while others utilizing nucleic acid-based technologies are still developing and will prove important to further our understanding of the biology of MRD. On the regulatory front, multiple retrospective individual patient and clinical trial level meta-analyses have already shown and will continue to assess the potential of MRD as a surrogate for patient outcome. Given all this progress, it is not surprising that a number of clinicians are now considering using MRD to inform real-world clinical care of patients across the spectrum from smoldering myeloma to relapsed refractory multiple myeloma, with each disease setting presenting key challenges and questions that will need to be addressed through clinical trials. The pace of advances in targeted and immune therapies in multiple myeloma is unprecedented, and novel MRD-driven biomarker strategies are essential to accelerate innovative clinical trials leading to regulatory approval of novel treatments and continued improvement in patient outcomes.
Keywords: transplantation; response; positron-emission-tomography; multiple-myeloma; t-cell; assessment; stem-cell; mass-spectrometry; survival outcomes; circulating tumor dna; multiparameter flow-cytometry; cxcr4-directed endoradiotherapy
Journal Title: Clinical Cancer Research
Volume: 27
Issue: 19
ISSN: 1078-0432
Publisher: American Association for Cancer Research  
Date Published: 2021-10-01
Start Page: 5195
End Page: 5212
Language: English
ACCESSION: WOS:000704224400007
DOI: 10.1158/1078-0432.Ccr-21-1059
PROVIDER: wos
PUBMED: 34321279
Notes: Article -- Source: Wos
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  1. Mikhail Roshal
    151 Roshal
  2. Katie Lynn Thoren
    33 Thoren